Provider Demographics
NPI:1992138572
Name:MCMAHON, KATELYN RYAN (PT)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:RYAN
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 TURNPIKE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6398
Mailing Address - Country:US
Mailing Address - Phone:978-688-6181
Mailing Address - Fax:978-688-5120
Practice Address - Street 1:1820 TURNPIKE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6398
Practice Address - Country:US
Practice Address - Phone:978-688-6181
Practice Address - Fax:978-688-5120
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist